Intelligent Systems to Support Crew Health and Performance During Earth-Independent Medical Operations
/“Sustained human presence and exploration throughout the solar system provides a value proposition for humanity that is rooted across three balanced pillars: science, inspiration and national posture," according to NASA’s Moon to Mars strategy and objectives. Sending a crew to Mars and safely returning them to Earth will rank among the most technically difficult endeavors ever attempted by humans, and will carry enhanced risks related to the astronauts’ health and well-being. Ejenta is collaborating with the AI Team in NASA’s Human Research Program and with Google, with support from the Translational Research Institute for Space Health (TRISH), to develop a technology aimed at reducing risks to deep space crew. The multi-disciplinary team will conduct technology demonstrations highlighting an artificial intelligence (AI) tool designed to provide clinical decision-making support.
As human spaceflight extends from low Earth Orbit (LEO) to lunar, and subsequently to Mars missions, there is an operational need for Earth-based medical expertise to transition from terrestrial to space-based assets to maintain optimal astronaut health and performance. The transition to Earth-independent medical operations (EIMO) will enable progressively resilient systems and crews to reduce risk, enhance wellness and promote overall mission success for deep space exploration. EIMO dictates that on-board care, response to unexpected medical events, and management of communication delays will increasingly become the purview of the crew.
EIMO will encounter multiple unique challenges. Long distances result in communication delays that will reduce the ability of Earth-based medical experts to provide real-time actionable support. In contrast to ground support that has been a critical component for crewed U.S. missions in LEO, round-trip communication delays for Artemis missions could be around 5-14 seconds, and Mars delays will increase to a maximum of ~44 minutes round trip. In the event of a time-sensitive medical emergency, the crew will have to act quickly given delayed ground-support and the scenario will become even more complicated if the patient is the designated crew medical officer. The crew will need onboard resources such as clinical decision-making support to respond to medical contingencies and maintain optimal crew health.
The emergence of large language models (LLM) has provided an opportunity to leverage AI for medical decision-making support. The NASA Team collaborated with Google to optimize an open-source LLM by training the model on Google’s Vertex AI platform using space medicine resources. The Team created a series of specialized LLMs in an agentic configuration, referred to as the Crew Medical Officer Digital Assistant (CMO-DA). One agent can guide an untrained user through the process of conducting an ultrasound examination of the kidneys or bladder. Ejenta added our platform, which is capable of integrating medical devices and environmental sensors that gather data with a suite of intelligent agents running in the local spaceflight environment. Through Ejenta’s platform, users can interact with their personal agents via multiple devices.
Through a service agreement administered by the Translational Research Institute of Space Health (TRISH), Ejenta provided access to our platform for integration with the CMO-DA. Working together, our combined teams have integrated the capability to capture imaging data using a point of care ultrasound probe. The CMO-DA was demonstrated to stakeholders in September at a training facility located within NASA’s Johnson Space Center. At that demonstration, the CMO-DA guided an individual designated as a crew medical officer through a simulated medical event (flank pain) to collect all the necessary data to arrive at a diagnosis and recommend options for treatment. The CMO-DA also assisted in performing an ultrasound to determine if the patient’s flank pain is caused by a kidney stone.
“Through our work with NASA’s AI team with financial support from TRISH, we were able to adapt our system to streamline ultrasound image data collection for the CMO-DA” stated Rachna Dhamija, Ph.D., Ejenta’s Founder and CEO. Dhamija continued, “successful demonstration of interoperability and integration will enable additional data streams to strengthen the CMO-DA situational awareness and enhance the ability to provide clinical decision support.”
“We are thrilled to support Ejenta and their effort to demonstrate the interoperability of their robust platform technology in collaboration with the AI Team from NASA’s Human Research Program as they explore the potential of tools such as CMO-DA to enable Earth-independent medical operations,” said Jimmy Wu, Deputy Director of TRISH.
Currently, the CMO-DA AI tool developed by NASA is in a prototype stage. It does not utilize personal health information; is not currently used to make operational decisions; and follows NASA Trustworthy A.I. Principles. Due to extensive input from flight surgeons and space medicine subject matter experts, the technology shows great potential to assist NASA’s highly skilled, non-medical astronauts in acquisition of clinically actionable ultrasound images.
In the near term, researchers at NASA envision continuation of building and testing the limits of this technology and understanding best practices and limitations within NASA frameworks. While NASA is not developing actual in-flight software, extending this technology to other scenarios where AI will be able to passively monitor medical data to support autonomous medical operations remains an objective.
About Ejenta
Ejenta automates remote health monitoring and care delivery, using AI technology exclusively licensed from NASA. “Intelligent agents” learn from connected devices and electronic health record data to monitor patients, predict health and connect care teams. Ejenta is rapidly expanding deployments with leading health providers, health insurers, academic medical centers, and the U.S. Government.
About TRISH
TRISH (Translational Research Institute for Space Health) is a lean institute empowered by NASA’s Human Research Program to help shape the future of human performance by rapidly ensuring astronauts and earthlings benefit from the latest space health advancements. TRISH serves as a link between space and health industries, focused on addressing operational needs and developing mission-critical tools, solutions and new leaders to advance the new era of space travel. With rigor, agility and efficiency, TRISH is advancing innovations and collaborations that will enable all humans to thrive, wherever they explore.